Impact of the COVID-19 Pandemic on the Professional Attitudes of Medical Students: A Pre-Post-Like Study.

OBJECTIVE: This study assesses the difference in professional attitudes among medical students, both before and after coronavirus disease 2019 (COVID-19), and identifies the determinants closely associated with it, while providing precise and scientific evidence for implementing precision education on such professional attitudes. METHODS: A pre-post-like study was conducted among medical students in 31 provinces in mainland China, from March 23, to April 19, 2021. RESULTS: The proportion of medical students whose professional attitudes were disturbed after the COVID-19 pandemic, was significantly lower than before the COVID-19 pandemic (χ2 = 15.6216; P < 0.0001). Compared with the "undisturbed -undisturbed" group, the "undisturbed-disturbed" group showed that there was a 1.664-fold risk of professional attitudes disturbed as grade increased, 3.269-fold risk when others suggested they choose a medical career rather than their own desire, and 7.557-fold risk for students with COVID-19 in their family, relatives, or friends; while the "disturbed-undisturbed" group showed that students with internship experience for professional attitudes strengthened was 2.933-fold than those without internship experience. CONCLUSIONS: The professional attitudes of medical students have been strengthened during the COVID-19 pandemic. The results provide evidence of the importance of education on professional attitudes among medical students during public health emergencies.

Exploration of the methods of establishing the minimum clinical important difference based on anchor and its application in the quality of life measurement scale QLICP-ES (V2.0) for esophageal cancer.

BACKGROUND: The development of the minimum clinical important difference (MCID) can make it easier for researchers or doctors to judge the significance of research results and the effect of intervention measures, and improve the evaluation system of efficacy. This paper is aimed to calculate the MCID based on anchor and to develop MCID for esophageal cancer scale (QLICP-ES). METHODS: The item Q29 (How do you evaluate your overall health in the past week with 7 grades answers from 1 very poor to 7 excellent)of EORTC QLQ-C30 was used as the subjective anchor to calculate the score difference between each domain at discharge and admission. MCID was established according to two standards, "one grade difference"(A) and "at least one grade difference"(B), and developed by three methods: anchor-based method, ROC curve method and multiple linear regression models. In terms of anchor-based method, the mean of the absolute value of the difference before and after treatments is MCID. The point with the best sensitivity and specificity-Yorden index at the ROC curve is MCID for ROC curve method. In contrast, the predicted mean value based on a multiple linear regression model and the parameters of each factor is MCID. RESULTS: Most of the correlation coefficients of Q29 and various domains of the QLICP-ES were higher than 0.30. The rank of MCID values determined by different methods and standards were as follows: standard B > standard A, anchor-based method > ROC curve method > multiple linear regression models. The recommended MCID values of physical domain, psychological domain, social domain, common symptom and side-effects domain, the specific domain and the overall of the QLICP-ES were 7.8, 9.7, 4.7, 3.6, 4.3, 2.3 and 2.9, respectively. CONCLUSION: Different methods have their own advantages and disadvantages, and also different definitions and standards can be adopted according to research purposes and methods. A lot of different MCID values were presented in this paper so that it can be easy and convenient to select by users.

The status quo of the occupational identity of the basic-level health technicians in Qiqihar City: an investigation and analysis.

OBJECTIVE: To investigate the occupational identity of primary health technicians in Qiqihar City and to analyze its influencing factors. METHODS: From September 2020 to October 2020, 436 primary health technicians were selected from the primary health centers in Qiqihar City using the convenience sampling method. After eight invalid questionnaires were excluded, the total number cases was 428. The questionnaires were used to conduct surveys and perform a data analysis. RESULTS: In Qiqihar City, the primary health technicians are densely distributed among community hospitals, township hospitals, and village clinics. The personnel include general practitioners, specialists, medical technicians, Chinese medicine practitioners, and nurses. The occupational identity of the basic-level health technicians in Qiqihar is at a medium level. The total job stressor scores among the primary health technical personnel in Qiqihar City and the total satisfaction scores are at the moderate level. The scores and total scores of each dimension of the job stressor scale were negatively correlated with the occupational identity scores (P<0.01). The scores and total scores of each dimension on the satisfaction scale demonstrated a positive correlation with the total professional identity scores (P<0.01). A very notable difference was found in the ages and years of work experience in the occupational identity scores in our univariate analysis (P<0.05). Our multiple linear regression analysis revealed that years of work experience, work pressure, and job satisfaction are the influencing factors of the status quo of the occupational identity of the basic-level health technicians (P<0.01). CONCLUSION: Years of work experience, work pressure, and the job satisfaction of primary health technicians are the influencing factors of their professional identity. Thus, strengthening humanistic care and communication, alleviating the psychological pressure of basic-level health technicians, rationalizing the work tasks, and providing more training and learning opportunities remain urgent tasks for boosting the professional identity of basic-level health technicians.

Knowledge-attitude-practice and psychological status of college students during the early stage of COVID-19 outbreak in China: a cross-sectional study.

OBJECTIVES: This study aimed to investigate the knowledge-attitude-practice (KAP) of Chinese college students regarding COVID-19 and evaluate their psychological status against the background of the COVID-19 outbreak. DESIGN: This was a cross-sectional study. SETTING: This study covered 31 provinces, municipalities and autonomous regions of mainland China. PARTICIPANTS: The participants, who were college students with ordinary full-time status, were surveyed anonymously on their KAP regarding COVID-19 by using self-made questionnaires. In addition, the Self-Rating Anxiety Scale was used to assess the psychological status of the students. METHODS: The online cross-sectional study among Chinese college students was conducted in February 2020. Logistic regression analysis was used to analyse the predictors of anxiety symptoms. PRIMARY OUTCOME MEASURES: The level of KAP and anxiety symptoms. RESULTS: A total of 740 college students from 31 provinces, municipalities and autonomous regions in China were recruited in the survey. Among them, 139 (18.78%) revealed having anxiety. Multivariable logistic regression analysis revealed that female gender was the risk factor for anxiety symptoms with an increased 2.164-fold risk than male gender (OR=2.164, 95% CI=1.279 to 3.662). The knowledge (OR=0.825, 95% CI=0.779 to 0.873) and attitude (OR=0.822, 95% CI=0.762 to 0.887) regarding COVID-19 were protective factors against anxiety symptoms. CONCLUSIONS: The level of KAP regarding COVID-19 was significantly negatively correlated with anxiety symptoms. Thus, understanding the level of KAP among college students during the early stages of major public health emergencies, such as a pandemic, is important. Such understanding plays an important role in adopting targeted health education strategies and reducing the psychological damage caused by these emergencies.

MiR-526b-3p Attenuates Breast Cancer Stem Cell Properties and Chemoresistance by Targeting HIF-2α/Notch Signaling.

Chemoresistance is a severe clinical challenge in breast cancer. Hypoxia and cancer stem cells (CSCs) contribute to the paclitaxel (PTX) resistance, but the molecular mechanisms are still elusive. MicorRNAs (miRNA) have been considered a promising therapeutic strategy in various cancers. Here, we identified the crucial function of miR-526b-3p in regulating PTX resistance and CSC properties. Our data demonstrated that miR-526b-3p mimic repressed the cell viability of breast cancer cells. The counts of Edu-positive cells were reduced by miR-526b-3p in breast cancer cells. Meanwhile, the apoptosis of breast cancer cells was induced by miR-526b-3p. Tumorigenicity analysis in the nude mice confirmed that miR-526b-3p attenuated the breast cancer cell growth in vivo. Significantly, hypoxia could enhance IC50 value of PTX in breast cancer cells. IC50 value of PTX was induced in breast cancer mammospheres. The hypoxia-inducible factor 2α (HIF-2α) expression was enhanced, but miR-526b-3p expression was repressed under hypoxia in breast cancer cells. Also, breast cancer mammospheres presented high HIF-2α expression and low miR-526b-3p expression. The inhibition of miR-526b-3p enhanced the IC50 value of PTX in breast cancer cells. MiR-526b-3p inhibitor enhanced the colony formation counts of PTX-treated breast cancer cells. The treatment of miR-526b-3p mimic suppressed the sphere formation counts of breast cancer cells and inhibited ALDH1 and Nanog expression. MiR-526b-3p was able to target HIF-2α in the cells. The overexpression enhanced but miR-526b-3p reduced the IC50 value of PTX in breast cancer cells, in which the overexpression of HIF-2α could rescue the miR-526b-3p-inhibited IC50 value of PTX. Overexpression of HIF-2α reversed miR-526b-3p-regulated apoptosis, colony formation ability, and ALDH1 and Nanog expression in the cells. Interestingly, the overexpression of HIF-2α induced but miR-526b-3p repressed the expression of HIF-2α, Hey2, and Notch in PTX-treated breast cancer cells, while HIF-2α could reverse the effect of miR-526b-3p. In conclusion, miR-526b-3p attenuated breast cancer stem cell properties and chemoresistance by targeting HIF-2α/Notch signaling. MiR-526b-3p may be utilized in the relieving chemoresistance in breast cancer.

Evaluation and design of public health information management system for primary health care units based on medical and health information.

OBJECTIVE: The objective is to understand the role of information management systems in the public health perspective of primary care units more accurately. METHODS: A public health information management system for primary medical units, which is based on electronic health records, virtual private network technology, real-time data storage, and other technologies, is designed on the premise of economical and straightforward operation. Besides, Xinhua Community Health Service Center Around the Wulong Street, Longsha District, Qiqihar City is selected as the experimental unit of the public health information management system, and the work efficiency of the system in the public health perspective of the primary medical unit is evaluated after 12 months of system operation. RESULTS: The public health information management system of primary medical units has following comprehensive management functions: health record management, child health, maternal health, health of the elderly, health of patients with chronic diseases, health of severe psychiatric patients, health education, infectious diseases and public emergencies, health events, health supervision, and management information. In addition, after 12 months of information management system operates in the grassroots units, the results show that patients and doctors have a very high satisfaction rate with the system. The system not only cultivates the excellent health and disease prevention awareness of residents but also improves the efficiency of primary care institutions, as well as reducing the number of patients seeking medical cares. CONCLUSION: The public health information management system of primary health care units based on medical and health information design is rich in functions with prominent work efficiency, which significantly improves the public health of grass-roots medical units. The research is useful and significant for follow-up studies on public health care systems.